A Multicenter Retrospective Study of Elective Neck Dissection for T1-2N0M0 Tongue Squamous Cell Carcinoma: Analysis Using Propensity Score-Matching

Mitsunobu Otsuru,Souichi Yanamoto,Kazuma Noguchi,Tomonao Aikawa,Yuichi Yamashita ,Yoshihide Ota,Masahiro Umeda,Tetsuro Yamashita,Kazunari Karakida,Tadahide Noguchi,Takahide Komori,Minoru Ueda ,Tadaaki Kirita,Masaya Okura,Takahiko Shibahara,Nobuhiro Yamakawa,Hiroshi Kurita ,Daijiro Kabata,Takumi Hasegawa,Hiroyuki Naito,Youichi Ohiro,Toshihide Kamata ,Ayumi Shintani

doi:10.1245/s10434-018-07089-7

Abstract

BackgroundThis multicenter retrospective study aimed to determine whether elective neck dissection (END) can be performed for T1-2N0M0 tongue cancer.MethodsPatients with T1-2N0M0 tongue squamous cell carcinoma who received treatment between January 2000 and December 2012 were enrolled at 14 multicenter study sites. The 5-year overall survival (OS) and 5-year disease-specific survival (DSS) were compared between the propensity score-matched END and observation (OBS) groups.ResultsThe results showed that the OS rates among the 1234 enrolled patients were 85.5% in the END group and 90.2% in the OBS group (P = 0.182). The DSS rates were 87.0% in the END group and 94.3% in the OBS group (P = 0.003). Among the matched patients, the OS rates were 87.1% in the END group and 76.2% in the OBS group (P = 0.0051), and the respective DSS rates were 89.2% and 82.2% (P = 0.0335).ConclusionThis study showed that END is beneficial for T1-2N0M0 tongue cancer. However, END should be performed for patients with a tumor depth of 4–5 mm or more, which is the depth associated with a high rate of lymph node metastasis. The use of END should be carefully considered for both elderly and young patients.

Highlights

This multicenter retrospective study aimed to determine whether elective neck dissection (END) can be performed for T1-2N0M0 tongue cancer
In 2015, D’Cruz et al.[13] reported the results of a randomized controlled trial that examined the effect of END on patients with N0 oral cancer
The results showed that overall survival (OS) and diseasespecific survival (DSS) in the END group were significantly superior to those in the OBS group

Summary

Introduction

This multicenter retrospective study aimed to determine whether elective neck dissection (END) can be performed for T1-2N0M0 tongue cancer. Propensity scores were computed using logistic regression with a variable indicating the presence or absence of END as an outcome, as a function of age, sex, performance status (Eastern Cooperative Oncology Group), clinical T stage, tumor depth, histologic grade, and year of operation.

Results

Conclusion